Nursing work environment impacts patient outcomes. This article summarized the concept and connotation of nursing work environment, related theories of how nursing work environment impacts patient safety outcomes and related researches conducted by foreign scholars. The effort of this review article aims to put forward new research direction.

Objective To describe the prevalence and change of rationing of nursing care (RNC) in medical and surgical units of level 2 and level 3 general hospitals across Guangdong province. Methods RNC were measured by asking nurses about the completion status of 12 necessary nursing care activities, and the prevalence of RNC in 2014 was compared with the study results from the China Hospital Nursing Workforce Research(CNWR) in 2009 (exclusively using the data of Guangdong province) to describe the change of RNC. Results Six activities were rationed averagely in 2014, and the most frequent activities rationed wereComfort/talk with patients accounted for 69.8% (975/1 396) andEducating patients and familiesaccounted for 67.3%(940/1 396). According to the CNWR in 2009, the average number of nursing care activities rationed was 3 which was statistically lower than the number in 2014 (P < 0.01). Conclusions RNC is prevalent in level 2 and level 3 general hospitals across Guangdong province, especially psychosocial care to the patients; the prevalence of RNC has not decreased since 2009.

Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.

Background Leber hereditary optic neuropathy (LHON) is mitochondrial DNA (mtDNA) disease and mainly leads to optical nerve degeneration.Its primary mechanism is synthesis disorder of DN4 protein due to variation of mtDNA 11778 locus.So to construct a vector with exogenous normal ND4 and transfect into mitochondria is a key of gene therapy for LHON.Objective This study was to investigate the in vitro transfection of adeno-associated virus (AAV)-ND4 gene into mitochondria.Methods Human renal epithelial cell lines transfected adenovirus E1A (293 cells) were regularly cultured and divided into two groups.Framework plasmids of recombinant AAV-ND4 or simple AAV2 were added to the cell medium respectively.The expression of ND4 in cells were located 12,24,36 and 48 hours after transfected by Y03 dual fluorescent quantum dots staining.The positive response for ND4 showed the green fluorescence.Results Cultured 293 cells grew well with 80％ confluence.Abundant green fluorescence particles were seen in cytoplasm in the AAV-ND4 transfected group,but only red fluorescence from mitochondrial protein was seen in the simple AAV transfected group under the fluorescence microscope.Conclusions Exogenous ND4 protein can been successfully transfected into mitochondria using the ND4 gene constructed AAV.This result provides experimental evidence for the further study on gene therapy of LHON.

Objective To explore the influencing factors of job burnout among nurses in level 2 and level 3 hospitals in Guangdong province. Methods A total of 2 066 first line nurses from 133 medical, surgical and intensive care units (ICU) of 23 level 2 and level 3 hospitals in Guangdong province were surveyed employing the questionnaire Hospital Nursing Human Resources Research during December 2013 to August 2014. Results In the multivariate logistic regression models, each additional doctor per nurse was associated with 1.34 times increase in the likelihood of high level of emotional exhaustion(EE). Nurses had a 57.4%higher risk of high level of EE when they worked overtime. Every one point increase in ancillary service score, and every one more year working as a nurse was associated with 5.4%, 2.3%increase in the likelihood of high level of EE, respectively. Nurses were 42.1%,40.9%more likely to exhibit high level of depersonalization(DP) when they worked in medical units or hospitals of level 3, compared with nurses of surgical units and hospitals of level 2. Nurses had a 29.5%higher risk of high level of DP when they worked overtime. Nurses holding higher positions had a lower likelihood(37.7%) of high level of reduced personal accomplishment(PA) compared with nurses holding lower positions. Nurses in medical units or ICUs had a 31.2%, 51.6%higher risk of high level of PA than nurses in surgical units, respectively. Conclusions Job burnout of nurses is at a quite high level in level 2 and level 3 hospitals in Guangdong province. The probability of the occurrence of burnout is related to the hospital, unit and nurse characteristics and nursing workloads.